A nurse is assisting with the plan of care for a client who is 4 hr postoperative from a subtotal thyroidectomy. Which of the following implementations should the nurse recommend?

Check for bleeding on the dressing at the back of the client’s neck.

Ensure that acetylcysteine IV is readily available.

Place the client in a side-lying position.

Check the client for asterixis.

Answer and Explanation

The Correct Answer is A

Choice A: Check for bleeding on the dressing at the back of the client’s neck. This is an implementation that the nurse should recommend for a client who is 4 hr postoperative from a subtotal thyroidectomy, which is a surgical removal of part of the thyroid gland. The nurse should check for bleeding on the dressing at the back of the client’s neck because this is where blood can pool and go unnoticed. Bleeding can cause hematoma, compression of the airway, and respiratory distress.

Choice B: Ensure that acetylcysteine IV is readily available. This is not an implementation that the nurse should recommend for a client who is 4 hr postoperative from a subtotal thyroidectomy. Acetylcysteine IV is an antidote for acetaminophen overdose, which can cause liver damage, but it is not related to thyroid surgery.

Choice C: Place the client in a side-lying position. This is not an implementation that the nurse should recommend for a client who is 4 hr postoperative from a subtotal thyroidectomy. The nurse should place the client in a semi-Fowler’s position, which is a position with the head of the bed elevated to 30 to 45 degrees. This position can facilitate breathing, reduce edema, and prevent aspiration.

Choice D: Check the client for asterixis. This is not an implementation that the nurse should recommend for a client who is 4 hr postoperative from a subtotal thyroidectomy. Asterixis is a sign of hepatic encephalopathy, which is a condition caused by liver failure, but it is not related to thyroid surgery.

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Correct Answer is ["A","C","E"]

Explanation

Choice A: Purple striations. These are also known as striae, and they are caused by the thinning and weakening of the skin and underlying connective tissue due to cortisol. They appear as purple or red lines on the abdomen, thighs, breasts, or arms.

Choice C: Buﬀalo hump. This is a term used to describe the accumulation of fat on the upper back and neck due to cortisol. It gives the appearance of a hump or a rounded shape.

Choice E: Moon face. This is a term used to describe the rounding and fullness of the face due to cortisol. It gives the

appearance of a moon-like shape.

Choice B: Tremors. These are not a clinical manifestation of Cushing’s syndrome, but rather a sign of hyperthyroidism, which is a condition caused by excess thyroid hormone production or exposure. Thyroid hormone aﬀects the nervous system and causes increased muscle activity and tremors.

Choice D: Obese extremities. These are not a clinical manifestation of Cushing’s syndrome, but rather a sign of hypothyroidism, which is a condition caused by low thyroid hormone production or exposure. Thyroid hormone aﬀects the metabolism of carbohydrates, proteins, and fats, and causes decreased energy expenditure and weight gain.

A. Faty stools B. Ecchymosis of the extremities C. Straw-colored urine D. Tenderness in the left upper abdomen

Correct Answer is A

Explanation

Choice A: Faty stools. This is a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis, which is the presence of gallstones in the gallbladder or bile ducts. The common bile duct carries bile from the liver and gallbladder to the duodenum, where it helps digest fats. If the common bile duct is obstructed by a gallstone, bile cannot reach the duodenum and fats cannot be properly absorbed. This results in fatty stools, which are also known as steatorrhea. Fatty stools are pale, bulky, greasy, and foul-smelling.

Choice B: Ecchymosis of the extremities. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Ecchymosis of the extremities is a sign of bleeding under the skin, which can be caused by trauma, coagulation disorders, or medications. It is not related to bile duct obstruction or gallstones.

Choice C: Straw-colored urine. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Straw-coloured urine is a normal colour of urine, which indicates adequate hydration and kidney function. It is not aﬀected by bile duct obstruction or gallstones.

Choice D: Tenderness in the left upper abdomen. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Tenderness in the left upper abdomen is a sign of splenomegaly, which is an enlargement of the spleen due to infection, inﬂammation, or cancer. It is not related to bile duct obstruction or gallstones.

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A nurse is assisting with the plan of care for a client who is 4 hr postoperative from a subtotal thyroidectomy. Which of the following implementations should the nurse recommend?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has Cushing’s syndrome. Which of the following clinical manifestations should the nurse expect to observe? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

A nurse is collecting data from a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

Correct Answer is A

Explanation

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